Blogs by Kara Wahlin, describing common issues faced by parents in the NICU and providing support and guidance for families facing them. Topics ranging from NICU discharge, advocacy in the NICU, interviews with NICU nurses, the struggles of quarantine, feeding challenges, coping with unsympathetic and/or oversympathetic family members or friends, book reviews of preemie stories, discussion of psychological issues faced by NICU parents, trauma, depression, stress and ways of coping through art and traditional therapy. This blog is a forum for NICU parents to find support during or after their infant's hospitalization in the NICU.

In a moment of crisis, the human mind (and body) manifests ways of coping that optimize our chances of survival. In fact, crisis, or trauma, oftentimes prompts our brain circuitry to circumvent the typical ways in which it operates so that we respond quickly and efficiently, leaving much of the process invisible to the conscious mind. Due to its invisibility, the brain's response to trauma leaves a lot of mystery for researchers to unravel; it can be even more difficult to navigate for an individual trying to heal from a traumatic experience. How is it then, that someone can deduce whether the trauma they've experienced has had an impact that's more than what might be considered "typical", or determine whether they might need more help?

It's sometimes useful to examine "mental health" issues outside of the traditional context assigned them by the world of mainstream psychology. Instead of imagining that trauma, depression, or crisis are a part of you, or that they've somehow become a part of your personality, try to tease out the practices and effects of these notions. In conducting such an investigation, you may be able to find what does and doesn't work for you or your family, and determine whether these practices or effects have become so significant that it might be useful to integrate the help of a professional.

What does the trauma have you doing? Do you have practices or beliefs specific to trauma that are active in your life? What do they look like? For example, one thing my trauma had me doing was researching, frantically, trying to figure out the various signs and signals that I thought might indicate there was something "wrong" with my son for the entire first year he was home. One sign or another would have me feeling paranoid, anxious, staying up at night, and at the same time paralyzed by fear. When our pediatrician, the specialists at our followup clinic, and various members of our family told me that there was nothing to worry about, it fell upon deaf ears. Upon examination, I realized that I had developed this practice when Elliott was still in the NICU, when it actually served a purpose: at that point, noticing discrete signs or signals that he might have difficulty with something or need more help in some arena gave me the ability to ask for guidance from the various medical professionals helping him on a daily basis. Panicking about things when he was an older baby, on the other hand, didn't serve much of a purpose except to manifest difficulty in feeling attachment with him, promote exhaustion, and create anxiety that tainted anything we did with a level of unease that didn't feel right.

The practices of trauma are wide and varied, and can range from things like not being able to sleep at night due to perseverative thoughts or fears, drinking to escape memories of the events that occurred, unrelenting fear that a similar event will occur again, or the inability to imagine a life without these fears. Some effects of trauma are more difficult to put your finger on, as they are physiological. They can include things like cold sweats, unpredictable crying or outbursts of anger, or simply feeling "outside of yourself" when in an environment that triggers memories of the crisis. Other practices of trauma may not be quite so harmful, and are just as useful to notice. These practices can include things like noticing milestones unique to your NICU baby, letting go of the unrealistic expectations society has of parents, accepting the unpredictability of the day-to-day by practicing mindfulness, or reaching out to help others going through a similar circumstance.

What promotes these practices? It can help to look at the various individuals, belief systems or values in your community that encourage the practices/effects of trauma you see active in your life, both the good and the bad. How do these individuals or institutions promote it?

To go back to the personal example I gave above, I realized that I had a deeply ingrained notion of what I now like to refer to as "the milestone police" (thank you for the terminology, online NICU support community!). Based on the books that I had read, I had unconsciously developed a very strong and particular sense of what I thought child development should look like. Because I held that notion much higher than my own intuition, I fell into a feedback loop in which everything seemed like it was somehow wrong. This was compounded by the fact that for 88 days while Elliott was in the NICU, I had to become accustomed to the fact that every day, something could very well go wrong, very easily and very quickly. In order to survive the circumstance, I had to get used to expecting the unexpected. Learning to let go of those shoulds and those fears, regardless of Elliott's outcome, gave me the ability to at least be present in the moment with him, and to focus on the things that I could do that were useful as opposed to exhausting (keep in mind, this is not to say that if you have a sense that something is awry with your baby that you should not reach out to your pediatrician or a specialist-- this example is an example, and not meant to be thought of as a replacement for medical or psychological advice).

Other examples of cultural constructs that promote the effects of trauma could be things like the isolation of going through a circumstance that no one in your community has ever spoken of or, potentially, experienced, which then can make your fears feel all the more horrifying to face. It can be "Dr. Google", or the practice of googling things and finding terrifying information that can send you into a tailspin of anxiety. It can be your family's support in your creation of a NICU journal or their curiosity about hearing your story, that encourages your ability to speak up about what you've been through and integrate it into your family's biography.

If you carefully examine the practices in which you participate, you will oftentimes find that people or belief systems play a role in their existence. It helps to know what those are, and to cultivate the positive influences, and minimize, or at least acknowledge, the negative to the best of your ability.

Are these practices of trauma ok with you? Take a look at the various practices/effects that you've found operating in your life and do a brief analysis. Are these things working for you? Are they working for your family? Your partnership?

As I mentioned above, sometimes the practices of trauma serve an important purpose at one point in your life (e.g. the NICU), but later, take away from your experience of things or prevent you from enjoying life in the way you want. Do you feel empowered to change these practices on your own, or could you use the assistance of another person in moving forward?

It can sometimes be very difficult to articulate the practices and effects of trauma, in which case it can help to have assistance in identifying what's happening and figuring out how to go on. Sometimes, the practices, effects or beliefs that you've developed can be so vast or overshadowing that it feels impossible to change them on your own, in which case, it may be useful to find an ally. On the other hand, sometimes a deep examination of the circumstances can empower you to find a path that works for you and your family on your own. Either way, making a space to examine the effects and practices that a crisis may have inspired in your life is a powerful start in moving towards healing.

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Keep in mind that as a therapist, I have an ethical obligation to protect the confidentiality of my clients. As such, please understand that comments on this blog asking for clinical advice, diagnoses, or addressing other psychological issues will not be answered, as this is a public blog and all responses will be viewed by third parties. If you are a client of NICU Healing or Kara Wahlin, please hold all clinical questions until we meet voice to voice or in person.

*These blogs are intended to be a starting point for discussion, and are not intended as psychological or medical advice.

*Please note that any comments that are detrimental or harmful in nature will be reviewed and deleted as such. This site is intended to provide users with support during a difficult time. Comments that do not reflect a supportive stance are not appropriate.

NICU Healing

NICU Healing is an online therapeutic resource designed for families currently in the NICU, recently released from the hospital, or coping with the residual effects of the trauma they experienced in having a preterm or medically complex infant. This site offers parents and family members access to free tips, educational materials and resources; it also offers a brief (6-8 week), for-pay group therapy program designed to help parents to cope with the trauma and depression that can be triggered by the NICU experience, and to understand, solidify and strengthen their attachment with their baby.